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Enhanced Cardiac Clearance of Iodine-123-MIBG in Chronic Renal Failure

Third and First Departments of Internal Medicine and Departments of Urology, Radiology, Clinical Laboratories, Hamamatsu University School of Medicine, Hamamatsu, Japan
Department of Internal Medicine, Hamamatsu Red Cross Hospital, Hamamatsu, Japan

Correspondence: For correspondence or reprints contact: Chinori Kurata, MD, Third Department of Internal Medicine, Hamamatsu University School of Medicine, 3600 Handa-cho, Hamamatsu 431-31, Japan.

ABSTRACT

We studied myocardial accumulation and clearance of [¹²³I]metaiodobenzylguanidine (MIBG) along with measurements of plasma norepinephrine concentrations. Methods: Myocardial imaging with MIBG and plasmanorepinephrine concentration measurements were performed in 21 patients with chronic renal failure on dialysis and 11 control subjects. Dynamic acquisitions, begun immediately after MIBG injection, and planar images 15 and 150 min after injection were used to measure early and late myocardial uptake and clearance rates of MIBG from the heart. Results: Early and late MIBG uptake was not significantly different from that in controls but MIBG clearance was significantly more rapid in controls. Based on echocardiographic findings, the patients were divided into three subgroups: those without left ventricular hypertrophy and dysfunction (n = 10), with hypertrophy (n = 4) and with dysfunction (n = 7). Among controls and the three patient subgroups, MIBG clearance was significantly higherin all the subgroups and also was significantly higher in patients with dysfunction than in those without hypertrophy and dysfunction. Plasma norepinephrine levels were significantly higher in patients than in controls and correlated significantly with the clearance rate. Conclusion: MIBG clearance from the heart was rapid in patients with chronic renal failure on dialysis, particularly those with left ventricular dysfunction or hypertrophy, suggesting cardiac sympathetic overactivity in these patients.

Key Words: iodine-123-MIBG • chronic renal failure • norepinephrine • left ventricular hypertrophy • congestive heart failure

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				C. Kurata, A. Uehara, and A. Ishikawa Improvement of Cardiac Sympathetic Innervation by Renal Transplantation J. Nucl. Med., July 1, 2004; 45(7): 1114 - 1120. [Abstract] [Full Text] [PDF]